4 - Impact of Hemoglobin and Platelet Trends on Clinical Outcomes in Acute Gastrointestinal Hemorrhage Embolization: Insights from 11 Years at a Tertiary Academic Center

To evaluate the relationship between patient’s laboratory courses through the hospital stay with clinical outcomes and adverse events in patients undergoing arterial angiography for acute gastrointestinal hemorrhage.

Materials and Methods: Patients who underwent arterial angiography for gastrointestinal hemorrhage between 2013 and 2024 were included in this study. Demographic and clinical information, along with pre-procedure hemoglobin and platelet levels, were collected. Post-procedure laboratory results and clinical courses were monitored. Patients who required additional interventions after the IR procedure were classified as clinical failures, while those discharged without the need for further intervention were considered clinical successes. Any adverse effects occurring within 30 days post-procedure were also recorded. Differences in laboratory values in relation to clinical success were analyzed statistically.

Results: A total of 347 angiographic procedures were performed on 282 patients, of whom 156 (55%) were male, with a median age of 65.5 years. A total of 215 embolization were carried out using eight different primary embolic agents. The median pre-procedure hemoglobin level was 7.9 g/L, and the median platelet count was 134,000/µL. The clinical success rate was 75.8%. Overall, changes in hemoglobin levels post-procedure did not show a significant difference in relation to clinical success. However, in patients with pre-procedure hemoglobin levels below 8 g/L, those who could not achieved clinical success exhibited a greater increase in hemoglobin on the first day after the procedure (22% vs 12%, p = 0.02). Patients with a greater drop in platelet levels on days 2 or 3 post-procedure were more likely to fail to achieve clinical success (12% and 14%, p = 0.04 and 0.004, respectively). Additionally, patients with higher platelet drop on days 2 or 3 post-procedure were significantly associated with more severe adverse events (-15% vs 0% and -23% vs 3%, adjusted p =0.04 and 0.008, respectively).

Conclusion: Hemoglobin changes in particular patient with low levels and platelet drop after the angiogram procedure are significantly associated with clinical success. Platelet drops were also associated with more severe adverse events.